A student nurse asks the RN about the clinical manifestations of a thoracic aortic aneurysm. Which of the following findings should the nurse discuss? (Select all that apply).
Shortness of breath
Difficulty swallowing
Upper chest pain
Diaphoresis
Cough
Hoarseness
Correct Answer : A,B,C,E,F
Choice A: Shortness of breath Shortness of breath can occur with a TAA due to the aneurysm compressing the trachea or the lung tissue. As the aneurysm enlarges, it can impinge on respiratory structures, leading to difficulty in breathing. A thoracic aortic aneurysm (TAA) is a bulging or dilation in the wall of the aorta as it passes through the chest cavity. TAAs can be life-threatening if they rupture or dissect and are often difficult to detect because they tend to grow slowly and usually do not cause symptoms until they become large or rupture.
Choice B: Difficulty swallowing Difficulty swallowing, or dysphagia, may be experienced if a TAA exerts pressure on the esophagus. This can happen when the aneurysm is located in the aortic arch, where the esophagus is in close proximity.
Choice C: Upper chest pain Upper chest pain is a common symptom of TAA and may be described as a deep, steady pain that can radiate to the back, neck, or jaw. The pain is caused by the stretching of the aortic wall and may be a warning sign of an impending rupture.
Choice D: Diaphoresis Diaphoresis, or excessive sweating, is not typically a direct symptom of a TAA. However, it can be associated with acute aortic syndromes, such as aortic dissection or rupture, which are medical emergencies.
Choice E: Cough A persistent cough can be a sign of a TAA, especially if the aneurysm is pressing against the trachea or bronchial tubes. The cough may sometimes produce blood if the aneurysm is causing erosion into these structures.
Choice F: Hoarseness Hoarseness can result from a TAA if the aneurysm compresses the recurrent laryngeal nerve, which controls the muscles of the voice box. This is known as Ortner’s syndrome or cardiovocal syndrome.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","E"]
Explanation
Choice A reason: Hypoxemia, or low oxygen levels in the blood, is a primary indicator of ARF as the lungs are unable to adequately oxygenate the blood.
Choice B reason: Confusion can result from hypoxemia or hypercapnia (high carbon dioxide levels) as the brain is sensitive to changes in blood gas levels.
Choice C reason: Dyspnea, or difficulty breathing, is a hallmark symptom of ARF as the lungs struggle to maintain adequate gas exchange.
Choice D reason: Bradycardia, or a slow heart rate, is not typically associated with ARF. Tachycardia, or a fast heart rate, is more common as the body attempts to compensate for hypoxemia.
Choice E reason: Hypocarbia, or low carbon dioxide levels, can occur in ARF if the body is attempting to compensate for hypoxemia by hyperventilating.
Correct Answer is A
Explanation
Choice A reason:Placing the client in a sitting position helps to lower blood pressure by promoting venous return and is the first action to take in cases of autonomic dysreflexia²³.
Choice B reason:While examining for skin breakdown is important, it is not the first action to take when autonomic dysreflexia is suspected.
Choice C reason:Checking the bladder for distention is a critical step, but it should be done after positioning the client to address immediate blood pressure concerns.
Choice D reason:Checking for fecal impaction is also important but follows the initial step of positioning the client to manage blood pressure.
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